Stroke and Vascular Research Centre, University of Manchester, Manchester, UK.
Clin Rehabil. 2013 Sep;27(9):785-91. doi: 10.1177/0269215513478227. Epub 2013 Mar 15.
OBJECTIVE: To investigate the feasibility and potential efficacy of 'activeTENS' (that is transcutaneous electrical nerve stimulation (TENS) during everyday activities) by assessing the immediate effects on strength, proprioception, balance/falls risk and mobility after stroke. DESIGN: A paired-sample randomized cross-over trial. SUBJECTS: Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS. SETTING: University clinical research facility. INTERVENTION: A single session of 'activeTENS' delivered via a 'sock electrode' (70-130 Hz, five second cycle) plus a session of control treatment (wearing the sock electrode with no stimulation), lasting approximately two hours in total. MAIN OUTCOMES: Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer, balance and falls risk (Standing Forward Reach Test) and gait speed (10-m walk test). RESULTS: All participants tolerated 'active TENS'. Most parameters improved during stimulation with activeTENS; balance (p = 0.009), gait speed (p = 0.002), plantarflexor strength (p = 0.008) and proprioception of plantarflexion (p = 0.029), except dorsiflexor strength (p = 0.194) and dorsiflexion proprioception (p = 0.078). CONCLUSIONS: The results provide initial evidence of the potential of 'active TENS' to benefit physical function after stroke which warrants further phase II trials to develop the intervention. Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported.
目的:通过评估日常生活中经皮神经电刺激(TENS)对力量、本体感觉、平衡/跌倒风险和移动性的即时影响,研究“主动 TENS”(即 TENS 治疗期间进行日常活动)的可行性和潜在疗效。
设计:配对样本随机交叉试验。
受试者:29 名移动性慢性脑卒中幸存者,无先前存在的限制平衡或移动性的条件,或对 TENS 有禁忌症。
地点:大学临床研究设施。
干预:单次“主动 TENS”治疗,通过“袜子电极”(70-130Hz,五秒周期)进行,加上单次对照治疗(佩戴袜子电极但无刺激),总时长约两小时。
主要结果:使用等速测力计测量背屈肌和跖屈肌力量和本体感觉、平衡和跌倒风险(站立前伸测试)以及步态速度(10 米步行测试)。
结果:所有参与者均耐受“主动 TENS”。大多数参数在主动 TENS 刺激期间有所改善;平衡(p=0.009)、步态速度(p=0.002)、跖屈肌力量(p=0.008)和跖屈本体感觉(p=0.029),除了背屈肌力量(p=0.194)和背屈本体感觉(p=0.078)。
结论:这些结果初步提供了“主动 TENS”在脑卒中后有益于身体功能的潜力的证据,值得进一步开展 II 期试验来开发该干预措施。没有证据支持刺激会对平衡产生不利影响并增加跌倒风险的担忧。
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